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c/insurancefights·submitted 2 years ago by u/milos_vestergaard

denial: the version I wish someone had shown me in week 1

Appealbranch of 6 comments

Quick one. Canada here. prior authorization works very differently where I live than in the threads that dominate the front page, and I keep seeing people confidently given advice that simply does not apply outside the US. Specifics: the route I used took 17 weeks and cost roughly what I expected. The admin was worse…

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6 comments, started 2 years ago
u/kasper_cabrera104 points·2 years ago
the VendorInvestigate number or it did not happen
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u/prior_auth_painMOD52 points·2 years ago

This is an urgent-care question wearing a forum question's clothes. Please contact a clinician rather than waiting for replies.

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u/maren_ibarra35 points·2 years ago

Small correction: the trial was 11 weeks, not 24. Does not change your point but people will quote it.

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u/kian_ferreira50 points·2 years ago

That is net peptide content, not purity. Different number, different meaning.

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u/pavel_nkemelu46 points·2 years ago

Yeah, the denial code matters, it tells you what to fight.

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u/hugo_pires38 points·2 years ago

do not suggest misrepresenting a diagnosis, that is fraud

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About c/insurancefights

The paperwork war. Prior-authorisation criteria, denial reason codes, step-therapy documentation, external review, employer carve-outs, and the appeal letter templates the community has iterated on for three years. Mostly US-shaped but the tactics generalise.

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